Valproic Acid Overdose: Case Report and Literature Review.
L-carnitine
meropenem
overdose
toxicity
valproic acid
Journal
The Journal of emergency medicine
ISSN: 0736-4679
Titre abrégé: J Emerg Med
Pays: United States
ID NLM: 8412174
Informations de publication
Date de publication:
11 2022
11 2022
Historique:
received:
08
03
2022
revised:
24
05
2022
accepted:
09
07
2022
pubmed:
14
10
2022
medline:
17
12
2022
entrez:
13
10
2022
Statut:
ppublish
Résumé
Valproic acid (VPA) is a common antiepileptic drug that is also used routinely for various psychiatric disorders. VPA toxicity typically manifests as central nervous system depression, while hyperammonemic encephalopathy and hepatotoxicity are potentially life-threatening complications. We describe the case of a 56-year-old man who presented to the emergency department after an intentional VPA overdose, was found to have hyperammonemia, and was treated with L-carnitine exclusively. He was subsequently admitted to the hospital for monitoring and serial laboratory testing. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although VPA toxicity has conventionally been managed by gastric decontamination, L-carnitine, and, in severe and refractory cases, extracorporeal removal, recent literature supports the use of carbapenem antibiotics, particularly meropenem. Thus, we report the details of current treatment modalities for VPA toxicity by reviewing current literature.
Sections du résumé
BACKGROUND
Valproic acid (VPA) is a common antiepileptic drug that is also used routinely for various psychiatric disorders. VPA toxicity typically manifests as central nervous system depression, while hyperammonemic encephalopathy and hepatotoxicity are potentially life-threatening complications.
CASE REPORT
We describe the case of a 56-year-old man who presented to the emergency department after an intentional VPA overdose, was found to have hyperammonemia, and was treated with L-carnitine exclusively. He was subsequently admitted to the hospital for monitoring and serial laboratory testing. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although VPA toxicity has conventionally been managed by gastric decontamination, L-carnitine, and, in severe and refractory cases, extracorporeal removal, recent literature supports the use of carbapenem antibiotics, particularly meropenem. Thus, we report the details of current treatment modalities for VPA toxicity by reviewing current literature.
Identifiants
pubmed: 36229318
pii: S0736-4679(22)00427-9
doi: 10.1016/j.jemermed.2022.07.009
pii:
doi:
Substances chimiques
Valproic Acid
614OI1Z5WI
Anticonvulsants
0
Carnitine
S7UI8SM58A
Types de publication
Case Reports
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
651-655Informations de copyright
Copyright © 2022 Elsevier Inc. All rights reserved.